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Pathophysiology > female GU > Flashcards

female GU Flashcards

1
Q

what are the 3 cell types in ovaries? what does each do?

A

Germ cells – produce oogonia
Granulosa cells- synthesize estradiol (aka estrogen)
Theca cells- synthesize progesterone (and with the help of granulosa cells also synthesize estradiol)

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2
Q

internal and external female genitalia include what components?

A

Internal – fallopian tubes, uterus, and upper third of the vagina
External – clitoris, labia majora, labia minora, and lower two thirds of the vagina

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3
Q

At ____ weeks gestation, the gonads are bipotential

At ____in genetic females the ovaries start to develop

A

5 weeks

9 weeks

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4
Q

Females don’t have the ____ hormone, so that they can form mullerian ducts

A

anti-mullerian hormone

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5
Q

what do the mullerian ducts develop into?

A

internal female structures (fallopian tubes, uterus, upper one third of the vagina)

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6
Q

Development of ______ and ________ does not require any hormones in embryo.

A

external genitalia and the internal genitalia

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7
Q

Growth of the female genitalia INTO NORMAL SIZE DOES depends upon ______. While lack of _____ allows for development of the female.

A

estrogen

testosterone

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8
Q

Ovaries perform __________ and __________; regulated by FSH and LH

A

steroidogenesis and gametogenesis (production of ova)

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9
Q

what hormones do the ovaries produce?

A

Ovaries produce estrogens, progesterone, and androgens.

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10
Q

what is the cervical os?

A

is the opening- doorway into the uterus

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11
Q

what are the 3 zones of the ovary?

A

Cortex-outer region, largest, contains all the oocytes enclosed in a follicle
Medulla-middle zone
Hilum-contains blood vessels and lymphatics

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12
Q

Interstitial cells- secrete ____
Follicles- contain ____
Corpus luteum- secretes ________

A

interstitial cells- estrogen
follicles- ova
corpus luteum- progesterone

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13
Q

what is the factory that produces the ova, as well as producing the female sex hormones ?

A

the ovary

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14
Q

four parts of the ovary?

A

Stroma- supporting tissues
Interstitial cells- secrete estrogen
Follicles- contain ova
Corpus luteum- secretes progesterone

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15
Q

puberty: Occurs when _______________ axis is activated and ___ release starts to become _______

A

hypothalamic-pituitary axis

GnRH release becomes pulsatile

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16
Q

what is adrenarche?

A

Adrenarche– onset of androgen dependent signs of puberty in boys or girls, including pubic hair, axillary hair, acne, and adult body odor

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17
Q

what is gonadarche?

A

Gonadarche– testicular or ovarian enlargement and beginning of gonadal hormonal function

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18
Q

the hypothalamus releases ______, which goes to the _______ _______. This is turn releases _______ and _______

A

GnRH (gonadatropin releasing hormone)
anterior pituitary
gonadotropic hormones (LH and FSH )

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19
Q

_______ and ______react with both the testes and the ovaries to stimulate hormone production and the start of “puberty” signs

A

FSH and LH

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20
Q

anterior pituitary hormones are produced in one of five cell types: what are these 5 cell types? which one do we care about?

A
  1. Somatotrophs
  2. Thyrotrophs
  3. Corticotrophs
  4. GONADOTROPHS– gonadotropins– follicle stimulating hormone (FSH) and luteinizing hormone (LH)
  5. Lactotrophs
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21
Q

LH and FSH over the lifetime of a female: when are they high and low?

A

childhood: steady state, ovaries are not active
puberty: a sharp increase (FSH >LH)
menstruating life: rise and fall consistent with menstrual cycles (LH > FSH)
menopause: FSH increases rapidly and stays very elevated

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22
Q

what levels can you test to see if a woman is going through menopause?

A

high levels of FSH

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23
Q

3 types of estrogen in the body

A

Estrodiol (largest amount in the body), Estrone and Estriol.

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24
Q

where does estrogen come from?

A

Secreted by the ovaries and in small amounts from the adrenals

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25
Q

estrogen is responsible for what 6 things?

weeds.. somewhat

A
  1. Normal female maturation
  2. Ovulation, implantation of the POC, pregnancy, parturition, and lactation
  3. Development of embryonic female genitalia
  4. Pubertal growth/development
  5. Maintain the normal skin and blood vessel structure
  6. Decreases the rate of bone absorption (decreases chances of osteoporosis)
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26
Q

menopausal women have osteoporosis due to what?

A

lack of estrogen

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27
Q

follicle stays as the ______ until you start menstruating (12 years or so), once menstruation you get _________ and _________.

A

primary follicle

an oocyte and secondary follicle

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28
Q

what are the 5 functions of progesterone? what is it secreted by?

A

secreted by corpus luteum in ovaries…

  1. Maintains pregnancy
  2. Decreases uterine contractions
  3. causes PMS symptoms
  4. Glandular development of the lobular and alveolar tissues of the breasts.
  5. Increases body temperature
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29
Q

Testosterone is secreted by ovaries____ of the time during reproductive years; _____ of the time it is secreted by the periphery and ovarian and adrenal precursors
Contributes to ________ at puberty

A

1/3, 2/3

normal hair growth at puberty

30
Q

oogenesis before puberty

A

germ cell–> mitotic division –>oogonia –> meiosis 1 meiosis 1 –>primary ooctyes (stuck in phrophase 1)

31
Q

oogenesis starting at puberty

A

primary oocytes until ovulation then meiosis 1 continues to secondary oocyte. (with help of LH and FSH)

32
Q

IF THERE IS _______, then meiosis II will occur and the secondary oocyte will become a _____

A

fertilization

zygote

33
Q

usually on day 14 of the 28 day cycle, what happens?

A

one secondary oocyte becomes the dominant* (ovulatory) follicle and the ova will be extruded from its follicle

34
Q

how many stages of follicular development?

A

3

35
Q

first stage of follicular development

A

parallels arrested prophase of oocyte, lasts for years; then with onset of menses, granulosa cells proliferate and nurture the oocyte
-the primordial follicle develops into the primary follicle

36
Q

second stage of follicular development

A

only happens after menses begins; during each menses only a few follicles enter into the second stage and develop into a graafian follicle

37
Q

3rd stage of follicular development

A

5-7 days after menses. Only one graafian follicle can become the dominant follicle and the rest regress. On day 14 (ovulation) of menses, the dominant follicle ruptures and releases its oocyte

38
Q

The residual contents of the ruptured primary follicle forms the ________ and is important for of the zygote should fertilization occur. If fertilization does NOT occur, then the __________ will ___________

A

corpus luteum
implantation and maintenance
corpus luteum it will regress

39
Q

if fertilization doesnt happen, _______doesnt happen, egg ______. and corpus luteum _______

A

meiosis II
egg dies off
corpus luteum erodes away

40
Q

corpus leuteum follicle is supposed to erode away, if it DOESNT then it can become …

A

an ovarian cyst, this doesn’t become a problem unless it becomes very large (over 5cm)

41
Q

oogenesis and follicular development happen at the same or different times?

A

same time

42
Q

normal menstruation parameters: age, cycle length and duration of bleeding

A

age of menarche in USA ~ 12.8 yrs.
cycle length: 28 + 7 days
duration of bleeding: 4 + 2 days

43
Q

normal menstruation parameters: volume, follicular phase, luteal phase

A

volume: ~30 mL
follicular phase: 0-14 days
luteal phase: 14 days

44
Q

regular menses usually follows menarche by____years

A

1-5 years

45
Q

3 phases of menses : what happens in each

A
  • follicular phase- estradiol on anterior pituitary: negative feedback loop
  • midcycle- estradiol on anterior pituitary: positive feedback loop, when we are ovulating.
  • luteal phase- progesterone on anterior pituitary: negative feedback loop
46
Q

menses: in which phases are there negative feedback loops, which are there positive feedback loops?

A

negative: 1st (follicular) and last (luteal)
positive: 2nd (mid-cycle)

47
Q

when you ask someone when were last period was, what should you specify?

A

you want the follicular phase, the first day of the last time they bled?

48
Q

in what days of the menstrual cycle is the woman actually bleeding?

A

day 0-4 (proliferative/follicular phase)

49
Q

If someone should get pregnant, then the progesterone continues to come from the _______until the ______ can take care of it

A

corpus luteum

placenta

50
Q

menstrual phase: the proliferative phase corresponds with the _____ phase in the ovary, secretory phase corresponds with the ____ phase in the ovary

A

proliferative- follicular

secretory- luteal

51
Q

what are the estrogen and progesterone levels in the follicular phase vs luteal phase?

A

estrogen: between the phases- spike in estrogen- helps initiate the LH surge (lets us know a woman is ovulating)
progesterone: low in follicular, rules the luteal/secretory phase (raised during this phase)

52
Q

proliferative phase: days ___ to ____

A

0-14

53
Q

what happens during the proliferative phase? (4 parts)

A
  1. estrogen: support and maintain the growth of the endometrium to get it ready for implantation.
  2. Follicle –> dominant follicle
  3. Phase dominated by estradiol; FSH and LH are inhibited by negative feedback
  4. Increase in the endometrial lining, causes growth of glands and the connective tissue of the stroma, and changes in cervical mucus (allow channels for sperm to travel through)
54
Q

what days does ovulation occur?

A

midcyle, day 14, for two days

55
Q

what happens in ovulation phase?

A

Ovulation follows a burst of estradiol at the end of the follicular phase causing a positive feedback on FSH and LH –> FSH and LH Surge

56
Q

ovulation always occurs ___ days prior to menses

A

14 (if it occurs at all!)

57
Q

when does the secretory phase occur?

A

day 14-28 (ends with the beginning of menses)

58
Q

what happens during the secretory phase?

A
  1. Progesterone secretion from the corpus luteum rises and stimulates the glandular cells to prepare the endometrium to receive a fertilized ovum
  2. Basal body temp increases
  3. If pregnancy does not occur, the corpus luteum starts to regress, progesterone and estrogen decline and the uterus can no longer support all this endometrial tissue. –> Necrosis of the tissue occurs and we are back at the beginning (or end) of the cycle again.
59
Q

increase in ________ in the secretory phase which causes _________ and helps with the ___________. This makes for a _____ _______menses.

A

prostoglandins
vasoconstriction and helps with the endometrial ischemia
short effective menses

60
Q

day _____ after fertilization the trophoblast secretes _____________, that stimulates the ovary to secrete the estrogen and progesterone that is required for the integrity of the conceptus.

A

6-8,

hormone, human chorionic gonadotropin (HCG)

61
Q

The secretion of the HCG corresponds to the time when the corpus luteum starts to ______ if there is no pregnancy.

A

corpus luteum starts to regress

62
Q

how long does the secretory/luteal phase last?

A

14 days (regardless of how many days the actual cycle was)

For example: If a person has a 28 days cycle they ovulate in the middle (day 14) and the luteal phase is 14 days
If a person has a 35 day cycle they ovulate on day 21 of their cycle (35-14=21)

63
Q

why is it so important that the secretory/luteal phase last 14 days?

A

This HAS to be so that the corpus luteum lasts long enough to keep the uterus ready for implantation if fertilization occurs (because it takes about 6-8 days for the trophoblast to start to stimulate the corpus luteum with HCG)

64
Q

when does each peak? FSH, LH, estrogen, progesterone?

A

FSH & LH: midcyle- between follicular and luteal phase (this is when ovulation occurs). LH>FSH (day 14)

estrogen: just before ovulation (end of follicular phase) (~day 12)
progesterone: broader peak through luteal phase ( ~day 19-24)

65
Q

The Hypothalamus produces what hormone that regulate the anterior pituitary?

A

Gonadotropin releasing hormone (GnRH)

66
Q

The anterior pituitary releases what hormones that stimulate the ovary to produce estrogen and progesterone and initiate ovulation?

A

gonadotropins -FSH and LH

67
Q

what does FSH do?

A

Follicle stimulating hormone (FSH)- stimulates follicle growth which increases estrogen; when estrogen reaches a certain level the FSH is negatively impacted and the LH can do its job.

68
Q

what does LH do?

A

initiates ovulation

69
Q

The ovary releases what hormone that controls the state of the uterus?

A

estrogen and progesterone

70
Q

where does estrogen come from in the ovary and what does it do?

A

Estrogen (follicle)
Supports endometrial growth, prevents breakthrough bleeding, stimulates and increase in endometrial progesterone receptors

71
Q

where does progesterone come from in the ovary and what does it do?

A

Progesterone (corpus luteum)
Maintains the secretory state of the uterus in preparation of fertilization and implantation.
Corpus Luteum only last about 9-10 days.

72
Q

what is a trophoblast?

A

cells forming the outer layer of a blastocyst, which provide nutrients to the embryo and develop into a large part of the placenta

Pathophysiology (28 decks)

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